The Risk of Re‐Institutionalization: Examining Rates of Admission to Long‐Term Care Among Adults with Intellectual and Developmental Disabilities Over Time
Bibliographic record
Abstract
Abstract Despite efforts toward community living for persons with intellectual and developmental disabilities, there is a risk of re‐institutionalization through placement in long‐term care facilities. To examine patterns of admission to long‐term care facilities in Ontario, Canada among adults with intellectual and developmental disabilities across key demographic and clinical variables, a cohort of 50 670 adults with intellectual and developmental disabilities was identified using administrative and clinical health data. Proportions admitted to long‐term care facilities between 2009 and 2013 were compared to proportions in a random sample of the general population. A greater proportion of adults with intellectual and developmental disabilities were admitted to long term care over the 4‐year period (4.5 vs. 0.9%). Mental health and addiction problems as well as frailty were more strongly associated with admission among adults without intellectual and developmental disabilities. The proportion of adults with intellectual and developmental disabilities admitted annually dropped from 1.6% (2009/10) to 1% (2012/13) while it remained stable among those without disabilities (∼0.3%); no change was observed in the proportion of younger adults with intellectual and developmental disabilities. A small proportion of younger adults with intellectual and developmental disabilities continue to be admitted to long‐term care. Research is needed to understand factors which predict admission in this group as well as age‐appropriate alternatives to long‐term care.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".